Safety of anemia drugs for cancer patients questioned, New York Times urges end to doctor rebates

05/18/2007

The same week that a group of FDA cancer experts warned of the potential harm of commonly-prescribed doses of anemia drugs to the cancer patients who receive them, the New York Times reported on a group of cancer doctors in the Pacific Northwest that made millions in dose-dependent rebates offered by the makers of the drugs, Amgen and Johnson & Johnson.

The intravenous drugs in question--Amgen's Aranesp and Epogen, and Johnson & Johnson's Procrit--are in a class of drugs called epoetin and darbepoetin, or EPOs, which increase bone marrow's red blood cell production and are delivered intravenously. Since 1996, when a clinical trial was stopped after dialysis patients being given large doses of EPO died, the Times reports that a minimum effective dose has not been researched. 

Though the mortality rate among dialysis patients in the U.S. has gone unchanged since the drug's introduction, dosage levels have continued to increase; average doses among dialysis patients in the U.S. are currently twice as high as those in Europe, and three times as high for U.S. cancer patients than for their European counterparts. 

The Times followed up with this editorial, "The Danger in Drug Kickbacks,"  calling for cautious prescribing by oncologists and an end to the anemia drug rebates, which are legal in spite of a ban on rebates for prescription drugs in pill form.